As part of our series of blogs throughout May 2021 for maternal mental health awareness month, Leanne Howlett describes her experiences of perinatal mental health.
Before I had children I had a really naive understanding of mental illness and believed I was immune to it. Five years on I have learnt the hard way the importance of recognising, understanding and looking after your mental health.
My son was born in 2016. When I went into hospital in labour I was so excited to meet my baby; however when he finally arrived after a long, traumatic labour I felt completely flat. I was so confused…this was meant to be the happiest moment of my life! Despite being in a room full of people, I’ve never felt so empty and alone. No one asked how I was, and, upon reflection I don’t know how I would even have explained it when I didn’t really understand it myself!
The next few weeks were a blur of feeding struggles, a hospital re-admission for sepsis and endless, sleepless nights. Every time I saw a healthcare professional they would talk to me about the baby’s weight and feeding, but never about me and how I was feeling. When they did ask how I was I was so scared to admit how I felt that I would plaster on a smile and tell everyone I was “fine” …but inside I just felt nothing.
I couldn’t understand what was happening, or why I couldn’t just feel the same as everyone else. When my son was about 5 weeks old I saw a midwife who was really concerned about my mental health. She suggested a referral to the perinatal mental health team, but I knew nothing about mental health services and the idea of it terrified me so I refused. She kept mentioning it to me and the more we talked about it the more I came around to the idea. I will never forget how nervous I was the day I had my first appointment with the team. I had no idea what to expect. I really struggled to engage initially and refused antidepressants because of the stigma attached to them. Looking back now, my head was in a constant battle between being too scared to engage in the support available, but knowing it was what I needed to get better.
Meanwhile, getting out of the house was such an effort, and when I wasn’t out, I’d sit on the sofa staring into space or crying. Even the simple things such as a making a cup of tea or a sandwich felt impossible.. We did baby classes with friends and I would post photos on Facebook of me smiling away ‘enjoying’ motherhood. I still didn’t feel like I was able to tell anyone how I really felt. Eventually I embraced the help available and antidepressants but by the time I did I was already at rock bottom and suicidal. Looking back I wish that I had felt able to accept the help sooner!
The decision to have a second child after this was incredibly difficult and one we put off for years. However in 2019 I fell pregnant. The pregnancy was filled with anxiety and I struggled with the idea of being pregnant. However, I knew the support was there and I had a quick referral into the perinatal mental health team where comprehensive support was put in place. Attending scans was hard and I couldn’t make it onto labour ward without experiencing a panic attack. I was diagnosed with Tokophobia, which until that point I had never even heard of! I was of course offered an elective c-section but because the majority of my trauma was centred around theatre I couldn’t face it. Against all the odds however, my little girl was born in our local birth centre in one of the pools following an incredibly short labour and no pain relief. It couldn’t have been any more different to my last experience. She took to feeding quickly and I felt really positive that I would remain well this time.
However, after an initial couple of good weeks she very quickly became an incredibly unsettled baby. She would cry for hours at a time, she wouldn’t sleep anywhere except on me and settling her was impossible. I started to feel anxious even when she did sleep, waiting for her to stir and would end up not sleeping myself, even when she did. I would lie there trying to sleep thinking ‘Is she going to wake up? Last night she stirred about now…I think I heard her stir’ until before I knew it she was awake again and I’d had no sleep at all.
Eventually my mood started to take a downward turn and my anxiety went through the roof. My anxiety started to manifest in other ways too – I became anxious about the children’s physical health – even my eldest who has never had any health concerns! Most nights I was getting less than 3 hours sleep and once the lack of sleep took hold my mood just plummeted and many of the all too familiar thoughts and feelings from my first postnatal period returned. I felt like I wasn’t good enough and every little thing that didn’t go quite right I would blame on me being a bad mum, a bad person, a bad friend. A lethargy washed over me and even simple things like making a sandwich for lunch or a drink felt like mammoth tasks which meant I wasn’t looking after myself at all. At one point I remember having to write a list of what I needed to do in the day and this consisted off getting up, making a cup of tea, getting changed… I am a productive busy person so looking back now I can see how unwell I was.
I would find everything in life too overwhelming from messaging friends to doing the food shop which meant I couldn’t even face doing the things I enjoyed. Soon enough the suicidal thoughts returned with a vengeance and they upped a gear when I started purchasing the means to carry out the thoughts. I was incredibly lucky to have intensive support from the perinatal mental health team (PMHT) and my health visitor. My CPN would check in twice a week and was so patient with me, even when she spent a whole day filling out forms to reserve a bed in a mother and baby unit and I then refused to go! My health visitor would also check in weekly and spend up to an hour at a time reminding me of why my children needed me and what I needed to fight for. These professionals gave me hope when I had none.
Slowly, by fully embracing my recovery and working incredibly hard at the techniques they taught me, I started to feel a little better. My sleep improved and I started to be able to distract myself from the dark thoughts. I stopped fighting the support and let them carry me through the recovery journey. Bit by bit I would notice the old me return. Sometimes only for a short period of time, but it was enough to give me a glimpse of recovery which I could then hold onto when the darkness fell again.
My CPN said to me when I was unwell that she was holding the hope for me that I would get better until I felt able to hold it myself. I never believed her but when I was sat there in my discharge appointment feeling excited for the life ahead and in control of my life again, I remembered that statement and realised how true it really was.
To the mum who puts on a brave face day after day when inside they are falling apart, please seek support. I was incredibly unwell but never once did a professional question my ability to be a loving mother to my children. There is no shame in needing support for your mental well being and everyone wants to help’.
Where to find additional information and support on maternal mental health
List of other international organisations: